Browsing by Author "Bhattarai, Tejaswee"
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Publication Barriers to Abortion among Women and Girls in Selected Districts of Nepal(Nepal Health Research Council, 2024) Phuyal, Parash Prasad; Bhattarai, Tejaswee; Pant, Prakash Dev; Devkota, Bishnu; Devkota, Jivan; Dhakal, Madhav Prasad; Karki, Sujan; Ghimire, Jagadishwo; Moore, BrittanyBackground: Even after two decades of legalization of abortion in Nepal, most women and girls still do not have knowledge on abortion legality and face abortion barriers. This study will explore perceived barriers to safe abortion and the factors associated with it. Methods: A Mixed method study design was conducted in 30 wards of 20 Municipals of seven districts of Lumbini and Sudurpaschim provinces. Quantitative data was analyzed for 673 women of reproductive age of 15-49 years. For qualitative data, key informant interviews were conducted. The analysis was done on five different barriers and a composite variable was created from them. Results: Most women and girls perceived social (34.6%), followed by family (30.6%), physical (30.6%), personal (29.5%), and health facility (14.9%) barriers to access safe abortion services. The key finding was that women and girls with knowledge on abortion legality were more likely to perceive barriers to abortion (AOR:2.31, CI:1.574-3.394). Women and girls with higher educational and economic status as well as Dalit women were less likely to perceive barriers to abortion services whereas never married women and girls perceived more barriers in accessing abortion services. Conclusions: Women and girls perceived several barriers to access safe abortion services. Women who have better knowledge on abortion legality recognize more barriers regarding abortion. This highlights the importance of raising awareness of women and girls on abortion rights to empower them in recognizing and advocating for the removal of the obstacles that stop them from getting abortion services. Keywords: Barriers to abortion; caste/ethnicity; legal knowledge; women and girls.Publication Understanding the Knowledge, Attitude, Practice and Intention regarding Abortion among Federal and Provincial Policymakers(Nepal Health Research Council, 2024) Bajracharya, Madhabi; Gyawali, Nisha; Bhattarai, Tejaswee; Joshi, Shipra; Devkota, Jivan; Devkota, Bishnu; Rai, Jayashree; Tandukar, Samasti; Timilsina, Amit; Shrestha Dangol, DeebBackground: For more than two decades abortion is legalized in Nepal, recognizing unsafe abortion as one of the leading but preventable cause of maternal morbidity and mortality. To safeguard safe abortion as women’s rights, several policies, guidelines, training manuals have been developed along with training human resources and increasing access to abortion services across Nepal. However, access to safe abortion services remains a challenge. Hence, to unravel the possible reasons behind these challenges, this study explored the knowledge, attitudes, practices and intentions of policymakers of Nepal towards abortion. Methods: Mixed methodology was used incorporating self-administered questionnaire for quantitative data collection and semi-structured interview guidelines to interview twenty local leaders from federal and provincial level, identified through purposive sampling. The ethical approval was taken from Nepal Health Research Council prior to data collection. After transcription and translation to English, Dedoose application was used for qualitative thematic analysis while the quantitative data was analysed using SPSS version.  Results: 70% understand that international health and human rights frameworks support abortion. Also, a majority (85%) believe that policies limiting abortion access create negative attitudes toward abortion. All the participants mentioned that they possess a good knowledge of safe abortion services. Majority of the participants had good attitude, confident in advocating, and had positive intention towards safe abortion services. However, existing socio-cultural barriers, lack of awareness, legal barriers and maintaining privacy were identified challenges to seek safe abortion and related services. Conclusions: Despite strong positive intentions, policy implementation gaps and lack of accountability have resulted in poor awareness, access, and acceptability of abortion related services. Further budget allocation, safe abortion prioritization, continuous advocacy, integration of abortion in preservice curriculum and community engagement and awareness will bridge these gaps – to ensure equitable access to quality services including women and girls from marginalized community and adolescents. Keywords: Intention; knowledge; policy gaps; policymakers; safe abortion.